Sterile transparent wound dressing, up to 16 sq in

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

TEGADERM 2" X 3"/ 1624W

Payers reporting HCPCS A6257

Payer pricing summary

Low

Average

$26

Median

High

$266

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +18 other terms	317	$2	$2	$2	77%	—	$0 – $17
2	Humana fee schedule · outpatient · +18 other terms	313	$2	$3	$4	115%	—	$0 – $24
3	Aetna fee schedule · outpatient · +16 other terms	270	$2	$2	$1	47%	—	$1 – $13
4	Blue Cross Blue Shield fee schedule · outpatient · +16 other terms	202	$2	$2	$1	40%	—	$0 – $9
5	WellCare fee schedule · outpatient · +8 other terms	185	$2	$2	$0	16%	—	$2 – $4
6	Devoted fee schedule · outpatient · +6 other terms	163	$2	$2	$0	2%	—	$2 – $2
7	Cigna Healthspring fee schedule · outpatient · +2 other terms	116	$2	$2	$0	3%	—	$2 – $2
8	Molina fee schedule · outpatient · +10 other terms	97	$3	$3	$1	38%	—	$2 – $6
9	Cigna fee schedule · outpatient · +14 other terms	83	$2	$9	$13	139%	—	$2 – $37
10	Anthem fee schedule · outpatient · +12 other terms	74	$2	$2	$0	8%	—	$2 – $4
11	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$2	$2	$0	0%	—	$2 – $2
12	Kaiser fee schedule · outpatient · +7 other terms	39	$2	$2	$0	2%	—	$2 – $2
13	Clover fee schedule · outpatient · +1 other terms	37	$2	$2	$0	3%	—	$2 – $2
14	Bcbs Tx fee schedule · outpatient	31	$2	$2	$1	29%	—	$2 – $8
15	Optum fee schedule · outpatient · +3 other terms	31	$2	$8	$9	109%	—	$2 – $31
16	Medica fee schedule · outpatient · +8 other terms	27	$3	$3	$2	63%	—	$0 – $5
17	MultiPlan fee schedule · outpatient · +14 other terms	25	$1	$6	$10	173%	—	$1 – $28
18	Oscar fee schedule · outpatient · +4 other terms	24	$2	$2	$0	3%	—	$2 – $2
19	Caresource facility · case rate · outpatient · +6 other terms	20	$15	$13	$7	53%	—	$2 – $27
20	Medicare fee schedule · outpatient · +7 other terms	18	$2	$2	$0	1%	—	$2 – $2
21	Amerihealth Caritas fee schedule · outpatient · +4 other terms	16	$3	$3	$0	2%	—	$2 – $3
22	Aetna Better Health fee schedule · outpatient · +5 other terms	13	$1	$2	$1	34%	—	$1 – $2
23	Highmark facility · fee schedule · outpatient · +5 other terms	13	$6	$8	$5	61%	—	$0 – $21
24	Wellmark fee schedule · both · +8 other terms	13	$2	$2	$0	3%	—	$2 – $2
25	Ambetter case rate · outpatient · +8 other terms	12	$3	$3	$0	4%	—	$3 – $3

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